Trauma Flashcards Preview

traction splints

used to counterbalance the pulling force of the muscles to reduce pain and prevent bleeding; immobilizes fractured limb to prevent further injury; used for femur fractures

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rigid splints

made of plastic, wood, cardboard to hold injured body part in a comfortable position

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compartment syndrome

after injury- bleeding and inflammation in the surrounding tissues causes pressure increases outside the blood vessels; excessive pressure can cut off blood supply to that area, making those cells hypoxic

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contusion

bruising

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neurogenic shock

also called neurogenic hypertension; results from injury to spinal cord that interupts nerves; without nerve imput, arteries dilate-->hypotensive, normal HR, skin is warm and flushed, disruption of autonomic pathways within spinal cord; different from hypovolemic shock because pulse/HR is normal rather than elevated and skin is warm and pink

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subdermal hematoma

buildup of blood between dura and arachnoid layers from veins rupturing under dura; slow bleeding; pressure builds and pushes on brain, may not see symptoms for a few days

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epidermal hematoma

bleeding between skull and dura layer; emergency situation; usually skull fractures are seen as well because only occurs with large force to head; rapid arterial and venous bleeding

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laceration

penetration wound

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basilar skull fracture symptoms

raccoon eyes, Battle's sign, CSF leakage

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Cushing reflex

a reflex used when intracranial pressure is high after head injury to relieve this pressure: late sign of high ICF; leads to Cushing's triad: increased blood pressure, decreased heart rate, irregular breathing

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meninges

layers of tissue protecting the brain; dura, arachnoid, pia

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consensual reflex

when you shine a light in one eye, both eyes should constrict, not just eye that was hit with light

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nonpurposeful reactions to pain

indicates deep state of unresponsiveness; 2 types: flexion-flex arms across chest and extend legs, and extension- arms down at side, extend legs, arch back

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potential signs of brain herniation

significant dilation of pupils more than 4mm, asymmetrical pupils, unresponsiveness to painful stimuli

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priaprism

involuntary erection seen in males who undergo spinal shock

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pericardial tamponade

fluid buildup in pericardial space within sac around the heart; puts pressure on the heart which decreases ventricular filling- decreases CO; Aka Beck's triad: JVD, weak pulse, drop in blood pressure (Paradoxus); treatment: pericardiocentesis- put a needle in and suck air out

DCAP BTLS

multiple casualty incident (MCI)

not enough resources to deal with the patient load from an emergency; open MCI if easy access to situation site; closed if situation site is difficult to get to and get patients out of

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active situation/incident

the force that caused the disaster is still going on; there is danger to anyone in the area- including first responders

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closed situation

forces that led to the accident is contained/exhausted

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3 stages of triad

1. triage of patients, label with tag2. treatment of patients after moving to safe area3. Only if needed- treatment at field hospital created on site

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Color scheme- Triage

Red- critical condition, needs treatment immediately, but with treatment has good chance of survival; Yellow- delayed/urgent, no signs of shock but may die if no treatment soon; Green- no major injuries; Black- dead, no signs of life/ability to save them

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START triage

Simple Triage And Rapid Treatment; initial assessment for each patient takes no longer than 30 seconds; initial treatment should only focus on life threatening conditions

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RPM's of triage

3 things to check: Respirations- open airway, if not breathing still- label black, if RR >30 or <10, label as red, move on to "P" if between 10-30; next assess Perfusion-if no pulse or capillary refill >2, label as red, if has pulse and cap. <2, check Mental status: If unconscious or AMS or can't follow simple commands, label as red. If able to follow simple commands, label as yellow. "30, 3, can do"

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Drowning

respiratory impairment due to submersion in water; classified as death, morbidity, no morbidity; lack of ventilation leads to hypoxia and the cardiac arrest; symptoms: cough, apnea or dyspnea, AMS or LOC, vomiting

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Aspirated water and drowning

10-20% of drowning patients don't aspirate any water, due to laryngospasm; victims that do aspirate water usually aspirate only a little bit; aspirated water can wash off surfactant- leads to alveoli collapse-respiratory arrest

ABCDE's of trauma

mediastinum

lobes of the lungs

right has 3, left has 2

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Pleural space

potential space between the parietal pleura (lines thoracic cavity) and visceral pleura (covers the lungs); usually this space does not contain anything; if air gets in space-pneumothorax, if blood gets in space-hemothorax

2 types of chest injuries

pulmonary contusion

bruise of the lungs; blossoms (gets larger) with time; give oxygen and ventilation

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Flail chest

3 or more ribs fractured in 2 or more places; have a floating segment that has paradoxical motion- floating segment moves independently of main ribs; ventilation/O2 if needed; monitor for pneumothorax, bulky dressing

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subcutaneous emphysema

bubble wrap/rice krispies- air gets trapped under the skin as result of rupture of part of airway; suspect pneumothorax until proven otherwise

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Pneumothorax

air accumulation in pleural space, lung fails to oxygenate blood and may collapse; 2 types- open: penetrating injury goes all the way through to the lungs, more and more air gets trapped; closed: blunt injury, skin not broken, could be from rib hitting lung; can remove air with chest tube or three sided dressing (flutter valve)